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Journal format
JABA L E T T E R S
TO
THE
ED ITO R
JA D A devotes this section to comment by readers on topics of current interest to dentistry. T he editor reserves the right to edit all com m unications to fit available space and requires that all letters be typed, double-spaced, and signed. No more than ten references should be given with each letter. Printed com m u nications do not necessarily reflect the opinion or official policy of the Association. Your participation in this section is invited.
have e q u a l applications.
effectiveness for
these
RICHARD J. HASTREITER, DDS, MPH MINNEAPOLIS, MN
wear, gowns and possibly caps, we rip it all off and go m outh-to-mouth in CPR. You have got to be kidding! I understand the question and there is a problem. JACK L. GILES, DMD GAINESVILLE, FL
Journal format Stannous fluoride □ I am surprised that a body as respected as the A m erican D ental A ssociation allowed the article on stannous fluoride to be printed in the February issue of The Journal (“ Is stannous fluoride gel an effective agent for prevention of oral disease?” by Richard J. Hastreiter, DDS, MPH). It was grossly biased against the use of stannous fluoride. . . . As a periodontist, I can attest to the fact that a stable 0.4% stannous fluoride gel is effective in relieving dentinal hypersensi tivity as well as preventing caries and aiding in supragingival plaque control. My practice has benefited from the use of these products, and I have found them to be of value as adjuncts in the treatment of periodontal patients. . . . WILLIAM E. MASON, DDS, MS SAGINAW, MI
□ A uthor’s response: Reasonable persons can disagree about the interpretation of some findings in a body of research as large as that which has been conducted on 0.4% stannous fluoride gels. Clinical impres sions, however, are not a substitute for valid scientific research. T h e research clearly does not support the concept that 0.4% stannous fluoride gels are the pre ferred preventive or treatment agents for hypersensitivity, plaque gingivitis, or periodontitis. T he only clinically proved, cost-beneficial indications for these gels are for the prevention of enamel décalci ficatio n in p a tie n ts w earing banded orthodontic appliances and for the preven tion of dental caries in patients who have had head and neck radiation therapy. However, other fluoride products may 522 ■ JADA, Vol. 118, May 1989
□ I appreciate the present format of The Journal. T he articles are set up so that they can be removed from The Journal and cataloged w ithout having overlap of other articles. As an oral and maxillofacial surgeon, not all articles are pertinent to my practice, but the ones that are, are removed and filed. It makes my life m uch easier to be able to remove and classify articles as they are laid out now rather than in the past when I often had to photocopy one page to divide articles. MARK E. BEEHNER, DDS EDWARDSVILLE, IL
Infection control and barrier techniques □ It is w ith a great deal of interest that I have read about sterilization, infection control, and barrier techniques. In my upbringing, I was always led to believe that a chain was no stronger than its weakest link. In regard to handpieces, I keep reading that “routine sterilization of handpieces between patients is desirable; however, not all handpieces can be sterilized.” So much for one weak link. T hen we are urged to use gloves and possibly masks to increase barrier proce dures. In Florida, we are commanded to take a course in CPR. If we do not successfully complete a CPR course, our license will not be renewed. Now, let me be sure I ’ve got this straight. We are using all these barrier techniques and practicing infection control, but we are not sterilizing the handpieces. After we have on our gloves, masks, protective eye
N ew dentists’ problem s □ As a practice consultant and practicing dentist, I have been disturbed by the widening gap between organized dentist ry’s perception of the work force glut and its real life im pact on today’s young practitioner. The current state of affairs for young dentists was well stated by Dr. Michael M. West in the January issue (Letters to the Editor). Unfortunately, his p re d ic am en t is becom ing the norm throughout this country as attested by the hundreds of practitioners I encounter as a co n su lta n t. T h is problem did not happen overnight, but I do not see any concrete action to correct it. However, on Feb 5, 1989, the New York Times contained a display ad soliciting applications from high school students to apply for a 7-year joint program at Tufts University leading to a DMD degree: “To meet the anticipated shortage of dentists. . . .” In addition, we have the ADA SELECT program to seek out high school students for dental school grooming; I am disappointed. Good candidates are selecting other careers for sound econom ic realities. Dentistry is no longer attractive to the best and the brightest. Until dentists can earn a respectable income comparable to the cost and investment in becoming a dentist, the profession w ill further decline as dental schools, w ith the blessing of organized dentistry, continue to be noth ing but trade schools pushing out grad uates to staff dental clinics. Soon, the only criterion for admission will be a heartbeat. It is time for leaders to stop propagating false hopes and start decreasing the production of graduates at the source.
TO
THE
ED ITO R
JA D A devotes this section to comment by readers on topics of current interest to dentistry. T he editor reserves the right to edit all com m unications to fit available space and requires that all letters be typed, double-spaced, and signed. No more than ten references should be given with each letter. Printed com m u nications do not necessarily reflect the opinion or official policy of the Association. Your participation in this section is invited.
have e q u a l applications.
effectiveness for
these
RICHARD J. HASTREITER, DDS, MPH MINNEAPOLIS, MN
wear, gowns and possibly caps, we rip it all off and go m outh-to-mouth in CPR. You have got to be kidding! I understand the question and there is a problem. JACK L. GILES, DMD GAINESVILLE, FL
Journal format Stannous fluoride □ I am surprised that a body as respected as the A m erican D ental A ssociation allowed the article on stannous fluoride to be printed in the February issue of The Journal (“ Is stannous fluoride gel an effective agent for prevention of oral disease?” by Richard J. Hastreiter, DDS, MPH). It was grossly biased against the use of stannous fluoride. . . . As a periodontist, I can attest to the fact that a stable 0.4% stannous fluoride gel is effective in relieving dentinal hypersensi tivity as well as preventing caries and aiding in supragingival plaque control. My practice has benefited from the use of these products, and I have found them to be of value as adjuncts in the treatment of periodontal patients. . . . WILLIAM E. MASON, DDS, MS SAGINAW, MI
□ A uthor’s response: Reasonable persons can disagree about the interpretation of some findings in a body of research as large as that which has been conducted on 0.4% stannous fluoride gels. Clinical impres sions, however, are not a substitute for valid scientific research. T h e research clearly does not support the concept that 0.4% stannous fluoride gels are the pre ferred preventive or treatment agents for hypersensitivity, plaque gingivitis, or periodontitis. T he only clinically proved, cost-beneficial indications for these gels are for the prevention of enamel décalci ficatio n in p a tie n ts w earing banded orthodontic appliances and for the preven tion of dental caries in patients who have had head and neck radiation therapy. However, other fluoride products may 522 ■ JADA, Vol. 118, May 1989
□ I appreciate the present format of The Journal. T he articles are set up so that they can be removed from The Journal and cataloged w ithout having overlap of other articles. As an oral and maxillofacial surgeon, not all articles are pertinent to my practice, but the ones that are, are removed and filed. It makes my life m uch easier to be able to remove and classify articles as they are laid out now rather than in the past when I often had to photocopy one page to divide articles. MARK E. BEEHNER, DDS EDWARDSVILLE, IL
Infection control and barrier techniques □ It is w ith a great deal of interest that I have read about sterilization, infection control, and barrier techniques. In my upbringing, I was always led to believe that a chain was no stronger than its weakest link. In regard to handpieces, I keep reading that “routine sterilization of handpieces between patients is desirable; however, not all handpieces can be sterilized.” So much for one weak link. T hen we are urged to use gloves and possibly masks to increase barrier proce dures. In Florida, we are commanded to take a course in CPR. If we do not successfully complete a CPR course, our license will not be renewed. Now, let me be sure I ’ve got this straight. We are using all these barrier techniques and practicing infection control, but we are not sterilizing the handpieces. After we have on our gloves, masks, protective eye
N ew dentists’ problem s □ As a practice consultant and practicing dentist, I have been disturbed by the widening gap between organized dentist ry’s perception of the work force glut and its real life im pact on today’s young practitioner. The current state of affairs for young dentists was well stated by Dr. Michael M. West in the January issue (Letters to the Editor). Unfortunately, his p re d ic am en t is becom ing the norm throughout this country as attested by the hundreds of practitioners I encounter as a co n su lta n t. T h is problem did not happen overnight, but I do not see any concrete action to correct it. However, on Feb 5, 1989, the New York Times contained a display ad soliciting applications from high school students to apply for a 7-year joint program at Tufts University leading to a DMD degree: “To meet the anticipated shortage of dentists. . . .” In addition, we have the ADA SELECT program to seek out high school students for dental school grooming; I am disappointed. Good candidates are selecting other careers for sound econom ic realities. Dentistry is no longer attractive to the best and the brightest. Until dentists can earn a respectable income comparable to the cost and investment in becoming a dentist, the profession w ill further decline as dental schools, w ith the blessing of organized dentistry, continue to be noth ing but trade schools pushing out grad uates to staff dental clinics. Soon, the only criterion for admission will be a heartbeat. It is time for leaders to stop propagating false hopes and start decreasing the production of graduates at the source.